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Abstract

Background : Sedentary lifestyle along with easy access to fast foods have resulted in a global epidemic of diabetes with a prediction that it will rise from the current estimate of 190 million to 324 million in 2025. WHO predicts that 170% increase of diabetes will be in the developing countries. Type 2 diabetes (T2DM) has become one of the major causes of premature illness and death and cardiovascular disease (CVD) will be responsible for up to 80% of these deaths. So it seems that at the moment we are faced with the twin pandemic of T2DM and CVD and the brunt of this would be borne by the developing countries. The clustering of central obesity, dyslipidaemia, hypertension, and hyperglycaemia known as metabolic syndrome has been associated with a 2-3 fold increase in T2DM and CVD. It is recognized that the features of the metabolic syndrome can be present 10 years preceding T2DM and CVD. The prevalence rates of metabolic syndrome appear varied using the WHO, EGIR, AACE, ATP III and IDF definitions. Therefore it is needed to study the suitability of metabolic syndrome definitions in this population.

Objective: To estimate the prevalence of metabolic syndrome in adults aged 25 years and above from an urban population of Karachi.

Methods: The survey was conducted from July to December 2004 by generating a computerized random sample of 500 households from houses in Lyari Town using a Geographical Imaging System (GIS). The survey activities were divided into two phases—the household interview and blood sample collection. Field work entailed visits to the selected household by a field team (medical students and health worker), introduction to the purpose of the research study, consent, interviews and physical measurements. In the 532 households visited 867 adults > 25 years old consented to take part in the survey out of which 363 gave blood samples.

Results: Prevalence of Diabetes was 9.4% while 5.6% had impaired fasting glucose (Abnormal glucose tolerance 15%). Prevalence of metabolic syndrome was found to be 49% by modified ATP III, 34.8% by IDF, 16.9% by AACE, 15.2% by EGIR and 7.4% by WHO definition. Insulin resistance defined by 75th percentile of HOMA-IR was measured as 1.94.

Conclusion: Inclusion of modified waist circumference and BMI cutoffs may help to predict metabolic syndrome more precisely as incorporated in modified ATP III and IDF definition. The rising prevalence of obesity and metabolic syndrome has received increased attention in recent years as both place individuals at risk for T2DM and CVD. Thus epidemiological and intervention trial studies which support lifestyle changes as the main modifiable risk factor in the treatment of individual components of the metabolic syndrome can then be initiated.